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Georgia rates for HCPCS L4360

Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$157.38 / $157.38 / $391.09
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$157.36 / $202.15 / $447.43
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$171.14 / $171.14 / $363.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$331.43 / $464.00 / $1,216.34
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$176.69 / $275.58 / $529.11
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$265.14 / $397.72 / $530.29
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$281.72 / $331.43 / $464.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$184.69 / $194.92 / $194.92
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$142.29 / $184.69 / $361.50
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$251.89 / $331.43 / $460.02
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$311.94 / $422.57 / $613.15
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$110.23 / $165.35 / $272.79